Now this might seem a strange article to follow the one entitled ‘The importance of good hygiene for good health’, but it is always crucial to strike a balance so that we don’t go too far in living in almost a sterile environment. 

The common belief that has driven medicine, as well as public perception and hygiene practices, is that when we get sick it’s because of something we ate, or inhaled, or were exposed to in other ways. The hygiene hypothesis, however, points in a different direction, proposing that in many diseases it is a lack of exposure to the “bad guys” that causes harm.

 

Increased hygiene and a lack of exposure to various micro-organisms may be affecting the immune systems of many populations – particularly in highly developed countries like the US and UK – to the degree that individuals are losing their bodily ability to fight off certain diseases. That’s the essence of the “hygiene hypothesis”, a fairly new school of thought that argues that rising incidence of asthma, inflammatory bowel disease, multiple sclerosis and perhaps several other autoimmune diseases may be, at least in part, the result of lifestyle and environmental changes that have made us too “clean” for our own good.

 

The hygiene hypothesis suggests that it is the more hygienic ones who are more susceptible to autoimmune diseases. The argument is – though we don’t yet have proof of it – that the immune system needs some kind of hardening, some kind of resistance in order to function optimally.

 

While the evidence is by no means clear-cut, some studies show that children who lived on farms when they were very young have a reduced incidence of asthma, which has led several researchers to conclude that organisms in cattle dust and manure may be the stimuli that their immune systems needed to fight off asthma. Other research found that ultra-clean children were more likely to suffer from eczema and/or wheezing than children with less hygienic habits. The more hygienic the child, the more likely he or she was to be affected.

 

Supporters of the hygiene hypothesis have not proposed that “playing in the dirt,” or making society less hygienic in general, are useful goals in medicine. But they do propose that to keep the immune system working properly, you need controlled stimulus or else it doesn’t know how to recognize the bad guys.

 

So, are we too clean? Research is definitely pointing to dirty kids being healthier kids, and growing up to be healthier adults. Dirt, it seems, isn’t always dirty, and bacteria isn’t always bad. Getting obsessive about cleanliness and sterilisation and keeping children ultra clean isn’t recommended, but this doesn’t mean hygiene isn’t important. Once again a balanced approach seems to be the answer. As long as you wash your hands at appropriate times and keep your living and working environment as clean you can but don’t get obsessive about it, you’ll be getting the balance about right. Life, after all, is for living, not for cleaning.

Regular massage can lower blood pressure, a US study has found. Researchers looked at a group of married couples who were given portable blood pressure monitors. Half the couples were told to massage their partners for 30 minutes three times a week while the other half went about their lives as normal. At the end of the four week experiment, both men and women in the massage group had significantly higher levels of oxytocin, a hormone that counteracts stress. The husbands in the group also had lower blood pressure readings than at the start of the study, whereas the non massage group saw no change.

Q: I’m approaching the menopause and am extremely worried about the risk of osteoporosis associated with it because my mother and grandmother both suffered from it. What can I do to prevent it?

A: A greater cause of immobility than strokes or heart attacks, osteoporosis (also known as brittle bone disease, when your bones become weak and fracture easily) results in disability, pain, loss of independence and even death. The risk of osteoporosis increases with age, especially after the menopause when oestrogen levels decline. Other risk factors are a slight build, family history of the disease, early menopause and chronic bowel problems like irritable bowel syndrome and diverticulitis. Some of these risks, like your family history, can’t be changed – but there are plenty of ways you can defend yourself against the onset of this disease. It’s never too late to start because diet and lifestyle changes can slow and reverse the symptoms at any age. In addition to eating a healthy diet, rich in phytoestrogens (naturally occurring forms of oestrogen) found in soybeans, wholegrains, flaxseeds and legumes, the recommendations that follow can help reduce your risk of osteoporosis:

Change your lifestyle: Women who sit for more than nine hours a day are twice as likely to have hip fractures as those who sit for less than six hours a day. So if you have a sedentary job or lifestyle you should build more exercise into your life. Activity is crucial because it helps build strong bones and muscles, so make sure you follow the menopause diet exercise guidelines. Don’t become a gym junkie though. Excessive exercising, as well as dieting and overeating, can increase the likelihood of developing the condition.

 

Avoid faddy diets: Without enough vitamin D, calcium and other valuable nutrients your body cannot defend itself against osteoporosis. So don’t follow faddy diets or crash diet as it deprives your body of the nutrients it needs to keep your bones healthy.

 

Stop smoking and drink in moderation: Women smokers generally have lower bone density and after the age of 40 they lose bone faster than non smokers. Excessive alcohol consumption interferes with the way your body handles calcium, increasing the amount you get rid of and decreasing the amount you absorb.

 

Eat for strong bones: Calcium is your vital mineral for the formation and continuing strength of your bones and teeth and a diet rich in it is your first step in protecting yourself against osteoporosis. Some women increase their intake of dairy foods to boost calcium intake, but this can be counter productive. Although these foods do provide us with calcium, the acidic nature of some dairy foods, particularly cheese, can in fact encourage our bones to release calcium rather than conserve it. Therefore, it’s important to look at other food sources. Calcium-rich foods include tinned sardines and salmon (with bones), seaweed, eggs, sesame seeds (tahini), figs, almonds, hazelnuts, walnuts, amaranth, spring greens, cabbage, broccoli, parsley, watercress, sunflower seeds, soya, chickpeas, black beans, pinto beans, buckwheat, brown rice and quinoa.

 

In addition to calcium you also need to get plenty of vitamin D, as without it your body can’t put calcium into your bones. Your body manufactures its own vitamin D when your skin is exposed to ultraviolet light from the sun, and 10 to 15 minutes daily exposure without sunscreen is perfectly safe in the early morning or late afternoon. The best dietary source of vitamin D is oily fish, although there are small amounts in egg yolks. If you don’t go out into the sunlight at all you should take vitamin D supplements. A strong skeleton also needs omega-3 fatty acids from flaxseeds and fish oil and vitamin K from green vegetables, which is vital for hardening calcium in your bones. Magnesium, found in nuts, seeds and peanut butter, is another vital mineral because it helps your body absorb calcium and vitamin D. And don’t forget to get enough vitamin B. A new study in the Journal of Clinical Endocrinology has found that elderly people with low levels of B vitamins are more likely to have hip fractures. Cereals, beans, fish and pulses are all good sources of the B vitamins.

 

Lose excess weight: But don’t get too thin or exercise too much. Your body needs some fat to produce oestrogen, which is produced in fat cells; thin women, especially those who diet and over exercise, are more likely to suffer from osteoporosis.

 

Watch your stress levels: When you are anxious your adrenal glands pump out a number of hormones including cortisol, which can increase the risk of fractures, so find ways to manage stress. I recommend yoga, breathing exercises and meditation – but find what works best for you.

Your risk of osteoporosis will be higher because of your family history, but it is not inevitable that you will have it too, so put into place preventative measures to protect yourself. For more detailed information on what to eat and what supplements to take, see my book ‘Osteoporosis – the silent epidemic’.